Years ago, while I was studying pharmacology, aspirin was viewed as a useful drug for relief from pain, fever and inflammation, and for preventing heart attacks and strokes. However, its potentially serious side effects of causing stomach bleeding or ulcers and tinnitus (ringing in the ears) rendered aspirin a relatively toxic drug. At that time, one of my professors told me: "If Aspirin was just coming onto the market today, it would not be approved for human use. Whether or not this is true is debatable. The test of time, however, has proven Aspirin to be an indispensable drug saving millions of lives and preventing a range of diseases including various cancers. Bowel cancer, often called a silent killer because of its apparent lack of symptoms, is the second most common cancer in Europe and the US. It's on the increase in developing countries, such as Egypt, due to the increasingly more Westernized diet. Screening is often carried out too late; and in the UK, approximately half of those diagnosed will die of the disease. Research published last week in the Lancet, suggests that a daily dose of 300mg or more of Aspirin over a prolonged period may protect against bowel cancer. The study showed that taking at least 300mg Aspirin a day for five years reduced the subsequent incidence of bowel cancer by 37 percent, and by 74 percent during the ten to 15 years after treatment. This protective effect was consistent regardless of age, sex, race or country of origin and was also seen in people who had a close family relative with bowel cancer, which normally increases their risk of contracting the disease by 2-4 times. The Lancet study confirms the results of several previous studies attributing Aspirin to bowel cancer prevention. Other cancers, such as those of the throat, mouth and esophagus, were also found to be dramatically lowered in studies where Aspirin was taken regularly for at least five years. Furthermore, a recent American study found that aspirin reduced the incidence of a range of cancers including breast, ovarian and prostrate cancer as well as boosting survival rates of those who did contract the disease. Anyone who has experienced a heart attack or stroke, will know that one of the first drugs prescribed by the physician will be Aspirin. It lowers the risk of heart attacks and strokes in high-risk patients by up to a third. Aspirin is also sometimes used as preventative measure against deep vein thrombosis in those people most at risk (such as after a major operation). But Aspirin's protective effects are not limited to preventing cancer and blood clots. Recent evidence suggests that Aspirin may also reduce the incidence of Alzheimer's disease. How does aspirin work? Aspirin (primarily composed of salicylic acid) inhibits substances involved in inflammation and platelets (blood cells) clotting. Aspirin prevents heart attacks by reducing the inflammation in the arteries that would cause it to harden, and reducing the occurrence of blood clots. Aspirin also inhibits key enzymes in the inflammatory process, one of which is cyclo oxygenase 2 (COX 2); COX2 levels are increased in many tumors and inhibiting this enzyme may lead to cancer cell death or suppress cancer cell development. Alzheimer's has an inflammatory component and aspirin may reduce its development through its inhibition of COX2. Should we take a daily dose of Aspirin to prevent cancer and degenerative disease and if so, at what dose? This is not an easy question to answer as Aspirin's serious side effects warrant a cautionary stance. As well as stomach bleeding and ulcers, long-term treatment with aspirin can lead to other serious side effects including prolonged bleeding and kidney damage. Aspirin is also contraindicated for children or teenagers as it can lead to the potentially fatal Reye s syndrome which affects the brain and liver, and for pregnant women as it can cause miscarriage. That said, many heart patients take 'baby' Aspirin, or 81 mg, which has been proven to be just as effective in protecting against heart disease as 300mg dose, but causes less internal bleeding. Some scientists even believe that people at high risk for bowel cancer (and perhaps other cancers and Alzheimer's) should consider taking a daily dose of aspirin under supervision of their physician. Many everyday vegetables, fruits and herbs contain high amounts of salicylic acid and eating more of these may be an alternative option to warding off diseases. Meanwhile, a new enzyme (COX 3) involved in inflammation has just been discovered to reside in the brain and heart that is also inhibited by aspirin, and will no doubt tell us more about the benefits of this fascinating drug. May El Meleigyholds a Ph.D in Immunology (London School of Hygiene and Tropical Medicine), an MSc in Toxicology/Pathology (Royal Postgraduate Medical School, London) and a BSc in Pharmacology (University College London). May is a medical and health journalist, and is a regular contributor to the British Medical Journal, Lancet, and WHO bulletin. May also produces health programs for Egyptian Television.
